서울행정법원 | 2016-11-04 | 2014구단54854
법원 판례 기준으로 판결요지와 원문 출처를 내부에서 확인하세요.
원문이 아닌 정리본이며, 저장된 요약의 끝부분이 잘려 있을 수 있습니다.
판정 결과
불안신경증 요양 종결 처분 및 외상후 스트레스 장애 추가 상병 불승인 처분 취소 청구가 모두 기각되었다.
핵심 쟁점
약 10년간 요양을 받은 업무상 불안신경증이 증상 고정에 이르렀는지, 새로 주장한 외상후 스트레스 장애가 별도의 업무상 질병으로 인정될 수 있는지가 쟁점이었다.
판정 근거
의학적 소견에 따라 불안신경증 증상이 고정 상태에 이르렀다는 판단이 타당하다고 인정되었다. 외상후 스트레스 장애는 업무 관련성과 발병 시점에서 인과관계가 인정되지 않아 불승인 처분이 적법하였다.
확보한 수집 내용입니다. 전문 여부와 앞뒤 누락, 문단·표·공백의 원형 보존은 확인되지 않았습니다.
공식 원문 미확인
서울행정법원 판결
사건: 2014구단54854 진료계획일부불승인 및 추가상병불승인처분취소 원고: A 피고: 근로복지공단 변론종결: 2016. 10. 21. 판결선고: 2016. 11. 4.
1. 원고의 청구를 모두 기각한다. 2. 소송비용은 원고가 부담한다.
1. 처분의 경위 가. 원고는 1984. 1. 9. 삼성생명보험 주식회사(이하 '소외 회사'라고 한다)에 입사하여 근무하던 중 2003. 5. 12. 업무로 인하여 '불안신경증'이 발병하였다는 이유로 피고에게 요양급여를 신청하였고, 2003. 7. 29. 요양승인(요양기간: 2003. 7. 25. ~ 2004. 1. 24.)을 받았다. 나. 원고를 치료하던 대구가톨릭대학병원은 원고가 '지속적 불안, 우울, 불면, 분노감, 집중력 저하가 지속되고 두통 등 신체증상이 동반되는 등 스트레스 요인이 많아 이에대한 격리가 필요'하여 요양기간을 연장하여야 한다는 이유로 2013. 6. 25. 피고에게 진료계획서(입원: 2013.
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\uc99d\uc0c1 \uc9c0\uc18d\uc73c\ub85c \uc694\uc591\uae30\uac04 \uc5f0\uc7a5\uc744 \uc2e0\uccad\ud568.\n- \ud53c\uace0\ub294 2014. 7. 15. \uc6d0\uace0\uc758 \ubd88\uc548\uc2e0\uacbd\uc99d\uc774 \ud1b5\uc0c1\uc801\uc778 \uc694\uc591\uae30\uac04\ubcf4\ub2e4 \uae38\uc5c8\uace0 \uc99d\uc0c1\uc774 \uace0\uc815\ub418\uc5c8\ub2e4\ub294 \uc774\uc720\ub85c 2013. 9. 30.\uae4c\uc9c0 \uce58\ub8cc\uae30\uac04\uc744 \uc815\ud558\uace0 \ub098\uba38\uc9c0 \uc9c4\ub8cc\uacc4\ud68d\uc744 \ubd88\uc2b9\uc778\ud558\ub294 \ucc98\ubd84(\uc774 \uc0ac\uac74 \uc81c1\ucc98\ubd84)\uc744 \ud568.\n- \uc6d0\uace0\ub294 2014. 2. 14. \uc8fc\uc694\uc6b0\uc6b8\uc7a5\uc560, \uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560\uc5d0 \ub300\ud55c \ucd94\uac00\uc0c1\ubcd1 \ubc0f \uc7ac\uc694\uc591\uc744 \uc2e0\uccad\ud568.\n- \ud53c\uace0\ub294 2014. 4. 21. \uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560 \uc9c4\ub2e8 \uc694\uac74 \ubbf8\ube44 \ubc0f \uc8fc\uc694\uc6b0\uc6b8\uc7a5\uc560\uc758 \uae30\uc874 \uae30\uac01 \uacb0\uc815 \ub4f1\uc744 \uc774\uc720\ub85c \ubd88\uc2b9\uc778 \ucc98\ubd84(\uc774 \uc0ac\uac74 \uc81c2\ucc98\ubd84)\uc744 \ud568.\n## \ud575\uc2ec \uc7c1\uc810, \ubc95\ub9ac \ubc0f \ubc95\uc6d0\uc758 \ud310\ub2e8\n### 1. \uc774 \uc0ac\uac74 \uc81c1\ucc98\ubd84\uc758 \uc808\ucc28\uc0c1 \uc704\ubc95 \uc5ec\ubd80 (\uc9c4\uc220\uad8c \ubc15\ud0c8 \uc8fc\uc7a5)\n- **\ubc95\ub9ac**: \uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95 \uc2dc\ud589\ub839 \uc81c43\uc870 \ub4f1 \uad00\ub828 \ubc95\ub839\uc0c1 \uc808\ucc28\ub97c \uc704\ubc18\ud558\uc600\ub294\uc9c0 \uc5ec\ubd80.\n- **\ubc95\uc6d0\uc758 \ud310\ub2e8**:\n- \uc6d0\uace0\uac00 \uc9c4\ub8cc\uacc4\ud68d\uc11c \uad00\ub828 \uc790\ubb38\uc758\uc0ac\ud68c\uc758\uc5d0 \ucc38\uc11d\ud558\uc5ec \uc11c\uba74 \uc9c4\uc220\uc11c\ub97c \ubc30\ubd80\ud558\uace0 \uc9c4\uc220\ud55c \uc0ac\uc2e4\uc774 \uc778\uc815\ub428.\n- \uc6d0\uace0\uc5d0\uac8c \ud68c\uc758 \ucc38\uc11d \ubc0f \uc758\uacac \uc9c4\uc220 \uae30\ud68c\uac00 \ucda9\ubd84\ud788 \ubd80\uc5ec\ub418\uc5c8\uc73c\ubbc0\ub85c, \uc774\ud6c4 \uc704\uc6d0\ub4e4\uc758 \uc758\ud559\uc801 \uc18c\uacac \ud45c\uba85\uc744 \uc704\ud55c \ud68c\uc758\uc5d0 \ucc38\uc11d\ud558\uc9c0 \ubabb\ud588\ub2e4\ub294 \uc0ac\uc815\ub9cc\uc73c\ub85c \uc774 \uc0ac\uac74 \uc81c1\ucc98\ubd84\uc744 \ucde8\uc18c\ud560 \uc815\ub3c4\uc758 \uc808\ucc28\uc0c1 \uc704\ubc95\uc740 \uc5c6\ub2e4\uace0 \ud310\ub2e8\ud568.\n### 2. \uc774 \uc0ac\uac74 \uc81c1\ucc98\ubd84\uc758 \uc2e4\uccb4\uc801 \uc704\ubc95 \uc5ec\ubd80 (\ubd88\uc548\uc2e0\uacbd\uc99d \uc694\uc591 \uc885\uacb0\uc758 \uc801\ubc95\uc131)\n- **\ubc95\ub9ac**:\n- \uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95 \uc81c5\uc870 \uc81c4\ud638\ub294 '\uce58\uc720'\ub97c \ubd80\uc0c1 \ub610\ub294 \uc9c8\ubcd1\uc774 \uc644\uce58\ub418\uac70\ub098 \uce58\ub8cc \ud6a8\uacfc\ub97c \ub354 \uc774\uc0c1 \uae30\ub300\ud560 \uc218 \uc5c6\uace0 \uc99d\uc0c1\uc774 \uace0\uc815\ub41c \uc0c1\ud0dc\uc5d0 \uc774\ub978 \uac83\uc744 \uc758\ubbf8\ud55c\ub2e4\uace0 \uaddc\uc815\ud568.\n- \uac19\uc740 \ubc95 \uc81c47\uc870 \ubc0f \uc2dc\ud589\ub839 \uc81c41\uc870\ub294 \uc694\uc591\uae30\uac04 \uc5f0\uc7a5 \ud544\uc694 \uc2dc \uc9c4\ub8cc\uacc4\ud68d \uc2ec\uc0ac \ud6c4 \uce58\ub8cc \uc885\uacb0 \ub610\ub294 \uae30\uac04 \ub2e8\ucd95 \uc870\uce58\ub97c \ud560 \uc218 \uc788\ub3c4\ub85d \uaddc\uc815\ud568.\n- \uac19\uc740 \ubc95 \uc81c51\uc870\ub294 \uc7ac\uc694\uc591\uc744, \uc81c57\uc870\ub294 \uc7a5\ud574\uae09\uc5ec\ub97c \uaddc\uc815\ud568.\n- **\ub300\ubc95\uc6d0 2009. 9. 10. \uc120\uace0 2009\ub4507332 \ud310\uacb0, \ub300\ubc95\uc6d0 2008. 9. 25. \uc120\uace0 2007\ub4504810 \ud310\uacb0 \ub4f1 \ucc38\uc870**: \uc694\uc591 \uc911\uc778 \uadfc\ub85c\uc790\uc758 \uc0c1\ubcd1\uc744 \ud638\uc804\uc2dc\ud0a4\uae30 \uc704\ud55c \uce58\ub8cc\uac00 \uc544\ub2c8\ub77c \ub2e8\uc9c0 \uace0\uc815\ub41c \uc99d\uc0c1\uc758 \uc545\ud654\ub97c \ubc29\uc9c0\ud558\uae30 \uc704\ud55c \uce58\ub8cc\ub9cc\uc774 \ud544\uc694\ud55c \uacbd\uc6b0\ub294 \uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95\uc0c1 \uce58\ub8cc \uc885\uacb0 \uc0ac\uc720\uc5d0 \ud574\ub2f9\ud568.\n- **\ubc95\uc6d0\uc758 \ud310\ub2e8**:\n- \uc6d0\uace0\uac00 10\uc5ec\ub144\uac04 \uc694\uc591\uce58\ub8cc\ub97c \ubc1b\uc558\uace0, \ud604\uc7ac\uae4c\uc9c0\ub3c4 \ud55c \ub2ec\uc5d0 \ud55c \ubc88\uc529 \uc9c4\ub8cc\ub97c \ubc1b\ub294 \uac83\uc740 \uc0c1\ubcd1 \ud638\uc804\uc774 \uc544\ub2cc \uc99d\uc0c1 \uc545\ud654 \ubc29\uc9c0\ub97c \uc704\ud55c \uce58\ub8cc\ub85c \ubcf4\uc784.\n- \uc9c4\ub8cc\uae30\ub85d\uac10\uc815\uc758\ub294 10\uc5ec\ub144\uac04 \ud638\uc804\ub418\uc9c0 \uc54a\ub294 \uac83\uc740 \ud658\uc790\uc758 \uc131\uaca9\uc801 \uc694\uc778\uc774\ub098 \uc0dd\ubb3c\ud559\uc801 \uc694\uc778 \ub4f1 \ub0b4\ubd80\uc801 \uc694\uc18c\uac00 \uc99d\uc0c1 \uc720\uc9c0\uc5d0 \uad00\uc5ec\ud560 \uac83\uc73c\ub85c \ud310\ub2e8\ub41c\ub2e4\ub294 \uc18c\uacac\uc744 \ubc1d\ud798.\n- \uc790\ubb38\uc758\ub4e4\uc740 \uc6d0\uace0\uc758 \ubd88\uc548\uc2e0\uacbd\uc99d \uc99d\uc0c1\uc774 \uace0\uc815\ub41c \uac83\uc73c\ub85c \ud310\ub2e8\ub41c\ub2e4\ub294 \uacf5\ud1b5\ub41c \uc758\uacac\uc744 \uc81c\uc2dc\ud568.\n- \uc774 \uc0ac\uac74 \uc81c1\ucc98\ubd84 \ub2f9\uc2dc \uc6d0\uace0\uac00 \ubd88\uc548\uc2e0\uacbd\uc99d \uc99d\uc0c1 \ud638\uc804\uc744 \uc704\ud574 2013. 9. 30. \uc774\ud6c4\uae4c\uc9c0 \uc801\uadf9\uc801\uc778 \uce58\ub8cc\ub97c \ud544\uc694\ub85c \ud558\ub294 \uc0c1\ud0dc\uc600\ub2e4\uace0 \ubcf4\uae30 \uc5b4\ub824\uc6b0\ubbc0\ub85c, \uc774 \uc0ac\uac74 \uc81c1\ucc98\ubd84\uc740 \uc801\ubc95\ud558\ub2e4\uace0 \ud310\ub2e8\ud568.\n#### \uad00\ub828 \ud310\ub840 \ubc0f \ubc95\ub839\n- **\uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95 \uc81c5\uc870(\uc815\uc758)**\n4. \"\uce58\uc720\"\ub780 \ubd80\uc0c1 \ub610\ub294 \uc9c8\ubcd1\uc774 \uc644\uce58\ub418\uac70\ub098 \uce58\ub8cc\uc758 \ud6a8\uacfc\ub97c \ub354 \uc774\uc0c1 \uae30\ub300\ud560 \uc218 \uc5c6\uace0 \uadf8 \uc99d\uc0c1\uc774 \uace0\uc815\ub41c \uc0c1\ud0dc\uc5d0 \uc774\ub974\uac8c \ub41c \uac83\uc744 \ub9d0\ud55c\ub2e4.\n- **\uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95 \uc81c47\uc870(\uc694\uc591\uae09\uc5ec\uc758 \uacb0\uc815)**\n- **\uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95 \uc2dc\ud589\ub839 \uc81c41\uc870(\uc694\uc591\uae09\uc5ec\uc758 \uacb0\uc815)**\n- **\uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95 \uc81c51\uc870(\uc7ac\uc694\uc591)**\n- **\uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95 \uc81c57\uc870(\uc7a5\ud574\uae09\uc5ec)**\n- **\ub300\ubc95\uc6d0 2009. 9. 10. \uc120\uace0 2009\ub4507332 \ud310\uacb0**\n- **\ub300\ubc95\uc6d0 2008. 9. 25. \uc120\uace0 2007\ub4504810 \ud310\uacb0**\n### 3. \uc774 \uc0ac\uac74 \uc81c2\ucc98\ubd84\uc758 \uc801\ubc95 \uc5ec\ubd80 (\uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560 \ubd88\uc2b9\uc778)\n- **\ubc95\ub9ac**: \uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560 \uc9c4\ub2e8 \uae30\uc900 \uc911 '\uc678\uc0c1\uc131 \uc0ac\uac74\uc758 \uacbd\ud5d8'\uc740 \uc8fd\uc74c, \uc2ec\uac01\ud55c \uc0c1\ud574 \ub610\ub294 \uc131\ud3ed\ub825\uc5d0 \ub300\ud55c \uc2e4\uc81c\uc801 \ub610\ub294 \uc704\ud5d8 \uacbd\ud5d8, \ubaa9\uaca9, \uac00\uae4c\uc6b4 \uc9c0\uc778\uc5d0\uac8c \uc77c\uc5b4\ub09c \uac83\uc744 \uc544\ub294 \uac83, \ub610\ub294 \ubc18\ubcf5\uc801\uc774\uac70\ub098 \uc9c0\ub098\uce58\uac8c \uc0c1\uc138\ud55c \uc815\ubcf4\uc5d0 \ub178\ucd9c\ub418\ub294 \uac83\uc744 \uc758\ubbf8\ud568. \ub2e8\uc21c\ud788 \ub530\ub3cc\ub9bc, \ud1f4\uc9c1 \uc555\ub825, \ud3ed\uc5b8, \uac15\uc81c\ud574\uace0, \uac00\ubcbc\uc6b4 \uc2e0\uccb4 \uc811\ucd09 \ub4f1\uc740 \uc815\uc2e0\ubcd1\ub9ac \uc720\ubc1c \ubc0f \uc545\ud654 \uc694\uc778\uc774 \ub420 \uc218 \uc788\uc73c\ub098 \uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560\ub85c \uc9c4\ub2e8\ud560 \uc218\ub294 \uc5c6\uc74c.\n- **\ubc95\uc6d0\uc758 \ud310\ub2e8**:\n- \uc6d0\uace0\uac00 \uce68\uc2b5\uc99d\uc0c1, \ud68c\ud53c, \uc778\uc9c0 \ubc0f \uac10\uc815\uc758 \ubd80\uc815\uc801 \ubcc0\ud654, \uac01\uc131\uc774\ub098 \ubc18\uc751\uc131\uc758 \ubcc0\ud654 \ub4f1 \uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560 \uc99d\uc0c1\uc744 \ubcf4\uc774\uace0 \uc788\uc74c\uc740 \uc778\uc815\ud568.\n- \uadf8\ub7ec\ub098 \uc6d0\uace0\uac00 \uc8fc\uc7a5\ud558\ub294 \uac10\uae08, \ud3ed\ud589 \ubc0f \ubbf8\ud589\uc774 \uc874\uc7ac\ud558\uc600\ub2e4\uba74 \uc678\uc0c1\uc131 \uc0ac\uac74\uc73c\ub85c \ubcfc \uc218 \uc788\uc73c\ub098, \uc81c\ucd9c\ub41c \uc99d\uac70\ub9cc\uc73c\ub85c\ub294 \uc6d0\uace0\uac00 \uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560 \uc9c4\ub2e8 \uae30\uc900\uc5d0 \ud574\ub2f9\ud558\ub294 \uc815\ub3c4\uc758 \uc2e0\uccb4\uc801 \uc704\ud611\uc744 \ubc1b\uc558\ub2e4\uace0 \uc778\uc815\ud558\uae30\uc5d0 \ubd80\uc871\ud568.\n- \ub530\ub77c\uc11c \uc6d0\uace0\uc5d0\uac8c \uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560\uac00 \ubc1c\uc0dd\ud558\uc600\ub2e4\uace0 \ubcfc \uc218 \uc5c6\uc73c\ubbc0\ub85c, \uc774 \uc0ac\uac74 \uc81c2\ucc98\ubd84\uc740 \uc801\ubc95\ud558\ub2e4\uace0 \ud310\ub2e8\ud568.\n## \uac80\ud1a0\n- \ubcf8 \ud310\uacb0\uc740 \uc0b0\uc5c5\uc7ac\ud574\ubcf4\uc0c1\ubcf4\ud5d8\ubc95\uc0c1 '\uce58\uc720'\uc758 \uac1c\ub150\uacfc \uc694\uc591 \uc885\uacb0\uc758 \ud310\ub2e8 \uae30\uc900\uc744 \uba85\ud655\ud788 \ud568. \ud2b9\ud788 \uc7a5\uae30\uac04\uc758 \uce58\ub8cc\uc5d0\ub3c4 \ubd88\uad6c\ud558\uace0 \uc99d\uc0c1 \ud638\uc804\uc774 \uc544\ub2cc \uc545\ud654 \ubc29\uc9c0 \ubaa9\uc801\uc758 \uce58\ub8cc\ub9cc \ub0a8\uc740 \uacbd\uc6b0, \uadf8\ub9ac\uace0 \ud658\uc790\uc758 \ub0b4\uc7ac\uc801 \uc694\uc778\uc774 \uc99d\uc0c1 \uc720\uc9c0\uc5d0 \uae30\uc5ec\ud558\ub294 \uacbd\uc6b0\ub97c \uce58\uc720 \uc885\uacb0 \uc0ac\uc720\ub85c \ubcf4\uc544 \uc694\uc591\uae09\uc5ec\uc758 \ud55c\uacc4\ub97c \uc124\uc815\ud568.\n- \ub610\ud55c, \uc678\uc0c1\ud6c4 \uc2a4\ud2b8\ub808\uc2a4 \uc7a5\uc560\uc758 \uc9c4\ub2e8 \uae30\uc900 \uc911 '\uc678\uc0c1\uc131 \uc0ac\uac74'\uc758 \uc5c4\uaca9\ud55c \ud574\uc11d\uc744 \ud1b5\ud574 \uc5c5\ubb34\uc0c1 \uc2a4\ud2b8\ub808\uc2a4\uac00 \uc815\uc2e0\uc801 \uace0\ud1b5\uc744 \uc720\ubc1c\ud560 \uc218 \uc788\ub354\ub77c\ub3c4, \ud574\ub2f9 \uc2a4\ud2b8\ub808\uc2a4\uac00 \uc9c4\ub2e8 \uae30\uc900\uc5d0 \ubd80\ud569\ud558\ub294 \uc2ec\uac01\ud55c \uc678\uc0c1\uc131 \uc0ac\uac74\uc5d0 \ud574\ub2f9\ud558\uc9c0 \uc54a\ub294\ub2e4\uba74 \uc0b0\uc7ac\ub85c \uc778\uc815\ud558\uae30 \uc5b4\ub835\ub2e4\ub294 \uc810\uc744 \uba85\uc2dc\ud568. \uc774\ub294 \uc0b0\uc7ac \uc778\uc815\uc5d0 \uc788\uc5b4 \uc758\ud559\uc801 \uc9c4\ub2e8 \uae30\uc900\uc758 \uc911\uc694\uc131\uc744 \uac15\uc870\ud55c \uc0ac\ub840\ub85c \ubcfc \uc218 \uc788\uc74c."}